Silva Laura Beatriz Borim da, Castilho Ivana Giovannetti, Souza Silva Fabiana Alves de, Ghannoum Mahmoud, Garcia Maíra Terra, Carmo Paulo Henrique Fonseca do
Departamento de Genética, Microbiologia e Imunologia, Instituto de Biociências de Botucatu, Universidade Estadual Paulista (UNESP), Botucatu 18618-689, SP, Brazil.
Departamento de Biociências e Diagnóstico Bucal, Instituto de Ciência e Tecnologia, Universidade Estadual Paulista (UNESP), São José dos Campos 12245-000, SP, Brazil.
Microorganisms. 2025 Jun 17;13(6):1406. doi: 10.3390/microorganisms13061406.
The global burden of fungal infections is rising at an alarming rate, with superficial, cutaneous, and mucosal mycoses among the most prevalent. Conventional treatments rely on oral and topical antifungal agents; however, these therapies are often limited by adverse effects, toxicity, frequent recurrence, and poor patient adherence due to prolonged treatment regimens. Moreover, the emergence of antifungal resistance and multidrug-resistant species such as and highlights the urgent need for alternative therapeutic strategies, such as antimicrobial photodynamic therapy (aPDT). aPDT is based on photophysical and photochemical processes involving a photosensitizer (PS), a light source, and molecular oxygen. When combined, these elements generate reactive oxygen species that selectively destroy microbial cells. In this review, we explore various PSs and their effectiveness in aPDT against infections caused by dermatophytes, spp., and other pathogenic fungi. Promisingly, aPDT has demonstrated antifungal activity against both susceptible and resistant strains. In addition, aPDT has been successfully used in cases of mycoses unresponsive to conventional therapies, showing favorable clinical outcomes and overall safety. Current evidence supports aPDT as a valuable strategy for the management of cutaneous, mucosal, and superficial fungal infections and as a potential strategy to combat antifungal resistance.
真菌感染的全球负担正以惊人的速度上升,其中浅表、皮肤和黏膜真菌病最为普遍。传统治疗依赖口服和外用抗真菌药物;然而,这些疗法常常受到不良反应、毒性、频繁复发以及由于治疗方案冗长导致患者依从性差的限制。此外,抗真菌耐药性以及如 和 等多重耐药菌种的出现凸显了对抗菌光动力疗法(aPDT)等替代治疗策略的迫切需求。aPDT基于涉及光敏剂(PS)、光源和分子氧的光物理和光化学过程。这些元素结合时会产生活性氧,选择性地破坏微生物细胞。在本综述中,我们探讨了各种PS及其在aPDT中针对皮肤癣菌、 属菌种和其他致病真菌引起的感染的有效性。有希望的是,aPDT已显示出对敏感和耐药菌株均具有抗真菌活性。此外,aPDT已成功用于对传统疗法无反应的真菌病病例,显示出良好的临床结果和总体安全性。现有证据支持aPDT作为治疗皮肤、黏膜和浅表真菌感染的有价值策略以及对抗真菌耐药性的潜在策略。
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